Technology-Enhanced Simulation for Health Professions Education

Cook, David A.; Hatala, Rose; Brydges, Ryan; Zendejas, Benjamin; Szostek, Jason H.; Wang, Amy T.; Erwin, Patricia J.; Hamstra, Stanley J.

doi:10.1001/jama.2011.1234

Cited by 1,526 publications

(1,240 citation statements)

References 28 publications

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“…Supplementing operating room practice with SBTT provides trainees with risk‐free opportunities to accelerate their skill learning15 16, but at the cost of additional time and risks of decay or poor translation to the operating room10. Such challenges are important for more complex skills such as laparoscopy18 20, 36.…”

Section: Discussionmentioning

confidence: 99%

“…Such challenges are important for more complex skills such as laparoscopy18 20, 36. Existing training strategies including motivation, feedback techniques and redistributed practice opportunities have modest effect sizes10 37, 38. Importantly, neuromodulation is compatible, and possibly even synergistic, with such approaches.…”

Section: Discussionmentioning

confidence: 99%

“…Simulation‐based task training (SBTT) provides an effective, risk‐free method of skill acquisition during surgical training and may reduce time to achieve skill proficiency10. Despite its value, SBTT suffers various limitations, including prolonged time requirements with modest effect sizes and variable long‐term retention of skills10 11.…”

Section: Introductionmentioning

confidence: 99%

“…Despite its value, SBTT suffers various limitations, including prolonged time requirements with modest effect sizes and variable long‐term retention of skills10 11. Defining methods to enhance SBTT holds the potential to accelerate training and optimize achievement of competency in complex skills such as surgery.…”

Section: Introductionmentioning

confidence: 99%

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Effects of transcranial direct-current stimulation on laparoscopic surgical skill acquisition

et al. 2018

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BackgroundChanges in medical education may limit opportunities for trainees to gain proficiency in surgical skills. Transcranial direct‐current stimulation (tDCS) can augment motor skill learning and may enhance surgical procedural skill acquisition. The aim of this study was to determine the effects of tDCS on simulation‐based laparoscopic surgical skill acquisition.MethodsIn this double‐blind, sham‐controlled randomized trial, participants were randomized to receive 20 min of anodal tDCS or sham stimulation over the dominant primary motor cortex, concurrent with Fundamentals of Laparoscopic Surgery simulation‐based training. Primary outcomes of laparoscopic pattern‐cutting and peg transfer tasks were scored at baseline, during repeated performance over 1 h, and again at 6 weeks. Intent‐to‐treat analysis examined the effects of treatment group on skill acquisition and retention.ResultsOf 40 participants, those receiving tDCS achieved higher mean(s.d.) final pattern‐cutting scores than participants in the sham group (207·6(30·0) versus 186·0(32·7) respectively; P = 0·022). Scores were unchanged at 6 weeks. Effects on peg transfer scores were not significantly different (210·2(23·5) in the tDCS group versus 201·7(18·1) in the sham group; P = 0·111); the proportion achieving predetermined proficiency levels was higher for tDCS than for sham stimulation. Procedures were well tolerated with no serious adverse events and no decreases in motor measures.ConclusionThe addition of tDCS to laparoscopic surgical training may enhance skill acquisition. Trials of additional skills and translation to non‐simulated performance are required to determine the potential value in medical education and impact on patient outcomes. Registration number: NCT02756052 (https://clinicaltrials.gov/).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of transcranial direct-current stimulation on laparoscopic surgical skill acquisition

et al. 2018

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“…Many experts now agree that traditional patient‐based training (apprenticeship model) can be associated with increased complications, patient discomfort, or erroneous diagnosis. The use of simulation‐based educational programs seems to be associated with improved patient outcomes, although there is still a paucity of evidence supporting this 6, 7. The presence of a trainee performing bronchoscopy has been shown to be associated with increased procedure duration and sedation quantity, and a higher complication rate 8…”

Section: Introductionmentioning

confidence: 99%

Influence of trainee involvement on procedural characteristics for linear endobronchial ultrasound

et al. 2017

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BackgroundLinear endobronchial ultrasound (EBUS) is a safe and effective method for the diagnostic sampling of mediastinal lymph nodes. However, there is a learning curve associated with the procedure and operator experience influences diagnostic yield. We sought to determine if trainee involvement during EBUS influences procedural characteristics, complication rate, and diagnostic yield.MethodsWe performed a retrospective analysis of 220 subjects who underwent an EBUS procedure at our center from December 2012 to June 2013. Procedures were performed by six different interventional pulmonologists with substantial experience with EBUS or by a trainee under their direct supervision. Procedural characteristics and complications were recorded. Diagnostic yield and specimen adequacy were compared between groups.Results EBUS was performed in 220 patients with a trainee involved (n = 116) or by staff physician alone (n = 104). Patient characteristics, and the number and size of lymph node stations sampled were similar. EBUS duration was longer (16.0 vs. 13.7 minutes; P = 0.002) and the total dose of lidocaine used was higher (322.3 vs. 304.2 mg; P = 0.045) when a trainee was involved. The rate of adequate specimens sampled was comparable between the groups (92.0 vs. 92.0%; P = 0.60). Diagnostic yield was lower when a trainee was involved in the EBUS procedure (52.6 vs. 68.3%; P = 0.02).ConclusionTrainee involvement significantly increased EBUS duration and the dose of local anesthesia used for the procedure. Diagnostic yield was lower when a trainee was involved. Factors accounting for this difference in yield, despite adequate samples being obtained, warrant further investigation.

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Learning to Detect, Categorize, and Identify Skin Lesions

et al. 2015

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Technology-Enhanced Simulation for Health Professions Education

Abstract: In comparison with no intervention, technology-enhanced simulation training in health professions education is consistently associated with large effects for outcomes of knowledge, skills, and behaviors and moderate effects for patient-related outcomes.

Cited by 1,526 publications

References 28 publications

Effects of transcranial direct-current stimulation on laparoscopic surgical skill acquisition

Effects of transcranial direct-current stimulation on laparoscopic surgical skill acquisition

Influence of trainee involvement on procedural characteristics for linear endobronchial ultrasound

Learning to Detect, Categorize, and Identify Skin Lesions

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